10 Gaps in the evidence
The Programme Development Group (PDG) identified a number of gaps in the evidence related to the programmes under examination based on an assessment of the evidence. These gaps are set out below.
1. There is a lack of evidence on the effectiveness and cost effectiveness of interventions that aim to increase the uptake of stop smoking interventions in secondary care settings. (An example includes interventions that identify and refer people to stop smoking services.)
2. There is a lack of evidence about the effectiveness of interventions to support temporary abstinence for people who use, work in or visit secondary care services.
3. There is a lack of high quality research to establish the long-term effectiveness and cost effectiveness of stop smoking interventions for people using mental health services (including Child and Adolescent Mental Health Services [CAMHS]).
4. There is a lack of evidence on the effectiveness and cost effectiveness of stop smoking interventions aimed at:
(a) secondary care staff
(b) partners, parents, other family and household members and friends or carers of someone using acute, maternity and mental health services
(c) secondary care patients and involving the use of varenicline or bupropion.
5. There is a lack of UK evidence on the effectiveness and cost effectiveness of incentives to encourage women who are pregnant or postpartum to quit.
6. There is a lack of data on the use of stop smoking services by people with a history of mental illness, because mental health history is rarely recorded by stop smoking service providers.
7. There is a lack of evidence on quality-of-life measures (such as EQ-5D) by smoking status for people using mental health services.
8. There is a lack of data to support economic evaluations of the cost effectiveness of stop smoking interventions for people who are using secondary care services.
9. There is a lack of evidence about the safety and efficacy of varenicline treatment for pregnant women.
10. There is a lack of evidence to determine the effect and acceptability of approaches that aim to match licensed nicotine-containing product(s) dose to level of smoking addiction among people who use acute, maternity and mental health services.
11. There was very limited evidence, particularly from the UK, on strategies for ensuring compliance with smokefree legislation and local smokefree policies. There was no evidence from well-conducted trials. There was little evidence about the effect of policies on smoking cessation or staff absenteeism.
The Group made 9 recommendations for research into areas that it believes will be a priority for developing future guidance. These are listed in Recommendations for research.